Atrial Fibrillation Treatment Costs, Hospitalizations Mount

May 3, 2011 -- People with atrial fibrillation, a common type of abnormal heart rhythm, are hospitalized twice as often as people without the condition, and costs of treatment are high, a new study suggests.

Not only are people with atrial fibrillation hospitalized more often, they have three times the rate of multiple hospitalizations compared to people without the disorder, and four times as many cardiovascular admissions, according to the study.

Treating people with atrial fibrillation added $26 billion to the nation’s health care bill in just one year, including $6 billion for atrial fibrillation care and $10.1 billion for non-cardiovascular health problems.

Atrial Fibrillation Hospitalizations, Cost on the Rise

“Atrial fibrillation places a huge economic burden on health care payers, patients, and our country,” says Michael H. Kim, MD, of Northwestern University and author of the study. “It is not clear that the country realizes that atrial fibrillation patients are much more likely to have cardiovascular hospitalizations specifically, and more hospitalizations in general.”

Atrial fibrillation is an irregular heart rhythm that occurs when the heart’s upper chambers beat erratically, causing chambers to pump blood inefficiently. It can cause blood to pool and clot in the chambers, increasing the risk of stroke and heart attack.

The condition affects about 3 million American adults, and that number is expected to double over the next 25 years, adding to the cost burden.

Study Methodology

Researchers examined data on 89,066 people with atrial fibrillation from two medical records databases that totaled 38 million people. The scientists matched patients with atrial fibrillation with a comparison group without the condition, and followed each pair for 12 months during 2004-2006.

Among key findings:

• 2.1% of patients with atrial fibrillation died in the hospital, compared to 0.1% without the condition.
• 75% of patients with atrial fibrillation were covered by Medicare.
• Atrial fibrillation patients entered the hospital, for any reason, twice as often as patients without the disorder and were three times as likely to have multiple hospitalizations.
• Atrial fibrillation patients were hospitalized for cardiovascular problems four times more than people without the problem, and had multiple cardiovascular hospital admissions eight times more often.
• Total direct health care costs averaged $20,670 for the atrial fibrillation group and $11,965 for those without the disorder. The difference of $8,705 was due mostly to inpatient services.
• Among patients studied, 19.5% of atrial fibrillation patients were newly diagnosed.

 “We’re not going to impact health care costs or cardiovascular outcomes by just addressing atrial fibrillation itself,” Kim says in a news release. “The large amount of cardiovascular disease among atrial fibrillation patients appears to worsen outcomes and increase costs. This is a sicker population.”

Almost Half a Million New Cases of Atrial Fibrillation Reported Annually

More than 460,000 new cases of atrial fibrillation are diagnosed every year, and it contributes to more than 80,000 deaths annually, according to the study.

“Atrial fibrillation is a significant issue and it is clearly causing primary hospitalizations, but we are likely underestimating its costs,” Kim says.

The study is published in Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association.

It was funded by the pharmaceutical company, Sanofi-Aventis US Inc.

Kim disclosed that he is a research consultant to the drug company and is on its speakers bureau and advisory board. One of the study authors, Mehul R. Dalal, PhD, of Northwestern, is an employee of Sanofi-Aventis. And Stephen Johnston, MA, Bong-Chul Chu, PhD, and Kathy L. Schulman, MA, are employees of Thomson Reuters, which has a research consulting agreement with Sanofi-Aventis.